Is W-Sitting Really a Problem?

We get asked about W-Sitting all the time, so I am going to start off the topic and share some information on this subject. If you have any questions or want to add more information, hit the REPLY button to this topic.

As an OT/PT team, we always promote floor time play for young kids, but some children find it most comfortable to sit by turning their legs outwards and backwards in the shape of a “W”. Many parents and teachers have heard about W-sitting, but are probably asking if this is really a problem, and if so, why?

:red_square: Unlike other sitting positions, when a child is sitting in a W position his legs provide a wide based of support, requiring very little activation of the core muscles. The W position may be a sign of trunk muscle weakness, which can lead to difficulty doing many gross and fine motor tasks along with trouble sitting for longer durations in school.

:red_square: W-sitting is a more static position, rather than a dynamic one. In this position, kids cannot easily lean in different directions or rotate their trunks and are therefore not fully engaging with their environment in a developmentally appropriate way.

:red_square: Even if there is no underlying cause for W-sitting, it can put a lot of stress on the hips and knees, potentially causing problems for these joints later on in life. Gently reminding your child to “fix his feet” early on, can help break the habit and encourage him to become more comfortable in other positions.

A good way to start helping your child avoid this position is by simply prompting with a verbal reminder, hand signal, or manually repositioning. Placing his legs straight out on front (long sitting), bending them by his side (side sitting), or advancing to criss-cross applesauce (tailor sitting) are good alternatives.

BOTTOM LINE: Kids may W-sit because of weaker core muscles or out of habit. It’s best to prompt your child out of this position to encourage the use of trunk muscles and prevent joint pain at the hips and knees later on

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Everything Allison said above is correct and great!!! But I might further add, that the knee is a hinge joint and The hip a ball and socket joint. While the hip may be able to handle internal rotation as seen with W sitting with less stress Due to the type of joint it is, the knee joint is not designed to have the lower leg rotate out . This occurs in W sitting and stresses the medial Collateral ligament of the knee and could permanently overstretch the MCL
Another alternative sitting position is heel sitting which is a quick fix from W sitting. The child is more inclined to stay this way with a verbal cue or touch cue . Heel sitting does not stress the MCL of the knee or internally rotate the ball n socket hip joint.
Jennifer Aguillard PT, PCS
@magicmomentstherapy

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Just say to your W sitter “ feet under your booty” and you have a heel sit!
You might have to position them this way at first :slight_smile:


Starting young to heel sit instead of W sit is also advised . Then it is never a bad habit developed in the first place . The above is a 5 month old baby with low tone due Down syndrome . Try it ! You’ll like it , they will thank you later in life when they have more core muscles and can tall kneel hold :))) :woman_kneeling:

A great point that the hip joint might be able to tolerate the W position more easily because of the way the hip bone and leg bone connect together and because the knee is shaped differently, this position could cause more stress on the knee ligaments.

I also love the suggestion of teaching your baby to sit in a low kneel (sitting with the bum on the heels) from early on! Great suggestion and love the video to help understand what that looks like

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Some really great information here.

In addition to the joint structure effects of W-sitting, it’s also important to note what role it plays in muscle length. We have some shortened muscles in the hamstrings, hip adductors, and calf and over lengthened muscles through the quads, and the muscles running along the front and side of the lower leg the ankle dorsiflexors and evertors. Over shortened and lengthened muscles can create a muscle imbalance and often times we can see the effects of this when kids begin to walk.

I love all of the suggestions on how to address this. Some additional options to add is to provide kids with alternative seating options such as a chair, stool, or sitting over a peanut ball or ride on toy. Also bringing toys off the floor surface to encourage positions such as high kneel or half kneel.

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I have also found that the more I can encourage a child to transition through the diagonals (not straight forward and back) the more I can help to prevent w-sitting.

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